Model-based glycaemic control in a Malaysian intensive care unit: performance and safety study

Background: Stress-induced hyperglycemia is common in critically ill patients. A few forms of model-based glycemic control have been introduced to reduce this phenomena and among them is the automated STAR protocol which has been used in the Christchurch and Gyulá hospitals' intensive care uni...

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Main Authors: Abu-Samah, Asma, Knoop, Jennifer, Abdul Razak, Athirah, Jamaludin, Ummu Kulthum, Mohamad Suhaimi, Fatanah, Md Ralib, Azrina, Mat Nor, Mohd Basri, Chase, Geoffrey, Pretty, Christopher G.
Format: Article
Language:English
Published: Dove Press Ltd 2019
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Online Access:http://irep.iium.edu.my/75582/
http://irep.iium.edu.my/75582/
http://irep.iium.edu.my/75582/
http://irep.iium.edu.my/75582/1/f_30-may-2019-mder-187840-model-based-glycemic-control-in-a-malaysia-intensive-care-un_50266.pdf
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spelling iium-755822019-11-25T00:56:54Z http://irep.iium.edu.my/75582/ Model-based glycaemic control in a Malaysian intensive care unit: performance and safety study Abu-Samah, Asma Knoop, Jennifer Abdul Razak, Athirah Jamaludin, Ummu Kulthum Mohamad Suhaimi, Fatanah Md Ralib, Azrina Mat Nor, Mohd Basri Chase, Geoffrey Pretty, Christopher G. R Medicine (General) Background: Stress-induced hyperglycemia is common in critically ill patients. A few forms of model-based glycemic control have been introduced to reduce this phenomena and among them is the automated STAR protocol which has been used in the Christchurch and Gyulá hospitals' intensive care units (ICUs) since 2010. Methods: This article presents the pilot trial assessment of STAR protocol which has been implemented in the International Islamic University Malaysia Medical Centre (IIUMMC) Hospital ICU since December 2017. One hundred and forty-two patients who received STAR treatment for more than 20 hours were used in the assessment. The initial results are presented to discuss the ability to adopt and adapt the model-based control framework in a Malaysian environment by analyzing its performance and safety. Results: Overall, 60.7% of blood glucose measurements were in the target band. Only 0.78% and 0.02% of cohort measurements were below 4.0 mmol/L and 2.2 mmol/L (the limitsfor mild and severe hypoglycemia, respectively). Treatment preference-wise, the clin- ical staff were favorable of longer intervention options when available. However, 1 hourly treatments were still used in 73.7% of cases. Conclusion: The protocol succeeded in achieving patient-specific glycemic control while maintaining safety and was trusted by nurses to reduce workload. Its lower performance results, however, give the indication for modification in some of the control settings to better fit the Malaysian environment. Dove Press Ltd 2019-09-01 Article PeerReviewed application/pdf en http://irep.iium.edu.my/75582/1/f_30-may-2019-mder-187840-model-based-glycemic-control-in-a-malaysia-intensive-care-un_50266.pdf Abu-Samah, Asma and Knoop, Jennifer and Abdul Razak, Athirah and Jamaludin, Ummu Kulthum and Mohamad Suhaimi, Fatanah and Md Ralib, Azrina and Mat Nor, Mohd Basri and Chase, Geoffrey and Pretty, Christopher G. (2019) Model-based glycaemic control in a Malaysian intensive care unit: performance and safety study. Medical Devices: Evidence and Research, 12. pp. 215-226. ISSN 1179-1470 https://www.dovepress.com/model-based-glycemic-control-in-a-malaysian-intensive-care-unit-perfor-peer-reviewed-fulltext-article-MDER 10.2147/MDER.S187840
repository_type Digital Repository
institution_category Local University
institution International Islamic University Malaysia
building IIUM Repository
collection Online Access
language English
topic R Medicine (General)
spellingShingle R Medicine (General)
Abu-Samah, Asma
Knoop, Jennifer
Abdul Razak, Athirah
Jamaludin, Ummu Kulthum
Mohamad Suhaimi, Fatanah
Md Ralib, Azrina
Mat Nor, Mohd Basri
Chase, Geoffrey
Pretty, Christopher G.
Model-based glycaemic control in a Malaysian intensive care unit: performance and safety study
description Background: Stress-induced hyperglycemia is common in critically ill patients. A few forms of model-based glycemic control have been introduced to reduce this phenomena and among them is the automated STAR protocol which has been used in the Christchurch and Gyulá hospitals' intensive care units (ICUs) since 2010. Methods: This article presents the pilot trial assessment of STAR protocol which has been implemented in the International Islamic University Malaysia Medical Centre (IIUMMC) Hospital ICU since December 2017. One hundred and forty-two patients who received STAR treatment for more than 20 hours were used in the assessment. The initial results are presented to discuss the ability to adopt and adapt the model-based control framework in a Malaysian environment by analyzing its performance and safety. Results: Overall, 60.7% of blood glucose measurements were in the target band. Only 0.78% and 0.02% of cohort measurements were below 4.0 mmol/L and 2.2 mmol/L (the limitsfor mild and severe hypoglycemia, respectively). Treatment preference-wise, the clin- ical staff were favorable of longer intervention options when available. However, 1 hourly treatments were still used in 73.7% of cases. Conclusion: The protocol succeeded in achieving patient-specific glycemic control while maintaining safety and was trusted by nurses to reduce workload. Its lower performance results, however, give the indication for modification in some of the control settings to better fit the Malaysian environment.
format Article
author Abu-Samah, Asma
Knoop, Jennifer
Abdul Razak, Athirah
Jamaludin, Ummu Kulthum
Mohamad Suhaimi, Fatanah
Md Ralib, Azrina
Mat Nor, Mohd Basri
Chase, Geoffrey
Pretty, Christopher G.
author_facet Abu-Samah, Asma
Knoop, Jennifer
Abdul Razak, Athirah
Jamaludin, Ummu Kulthum
Mohamad Suhaimi, Fatanah
Md Ralib, Azrina
Mat Nor, Mohd Basri
Chase, Geoffrey
Pretty, Christopher G.
author_sort Abu-Samah, Asma
title Model-based glycaemic control in a Malaysian intensive care unit: performance and safety study
title_short Model-based glycaemic control in a Malaysian intensive care unit: performance and safety study
title_full Model-based glycaemic control in a Malaysian intensive care unit: performance and safety study
title_fullStr Model-based glycaemic control in a Malaysian intensive care unit: performance and safety study
title_full_unstemmed Model-based glycaemic control in a Malaysian intensive care unit: performance and safety study
title_sort model-based glycaemic control in a malaysian intensive care unit: performance and safety study
publisher Dove Press Ltd
publishDate 2019
url http://irep.iium.edu.my/75582/
http://irep.iium.edu.my/75582/
http://irep.iium.edu.my/75582/
http://irep.iium.edu.my/75582/1/f_30-may-2019-mder-187840-model-based-glycemic-control-in-a-malaysia-intensive-care-un_50266.pdf
first_indexed 2023-09-18T21:46:55Z
last_indexed 2023-09-18T21:46:55Z
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